ABSTRACT Errors in radiation therapy (RT) are estimated to occur in up to ? 5% of the > ?600,000 patients receiving RT per year in the US; with serious/lethal events occurring ? 1 of 1,000-10,000 patents. The specific aim of this proposal is to develop and assess the impact of and generalized simulation based training and neurofeedback intervention on radiation therapists (RTTs) mental workload, situation awareness and performance. Mental workload will be assessed via NASA Task Load Index (NASA-TLX). Situation Awareness will be assessed using Situation Awareness Rating Technique (SART) and situation awareness global assessment technique (SAGAT). Performance will be assessed using procedural compliance (including detection of embedded errors) and time-to-complete the task. Subjects, randomized to +/- simulation-based training, and +/- neurofeedback, will have pre- and post-intervention assessments of mental workload, situation awareness, and performance. Using a 2 x 2 balanced randomization design, we will use ANOVA to analyze the results.